Pathological findings in COVID-19: A conventional autopsy-based study from India

Background & objectives: Autopsy study has been considered the gold standard method for studying the effects of any disease on the body. Since COVID-19 is a novel disease, autopsy is crucial to understand its pathophysiology. This study was conducted to analyze the microscopic and macroscopic findings of various organs in COVID-19 and to associate those findings with clinical observations and laboratory findings. Methods: Conventional invasive autopsies were performed on 33 patients with COVID-19 from September 7, 2020 to December 23, 2020. All the organs were removed by routine dissection techniques and preserved in 10 per cent formalin. The tissues were processed and stained according to standard practices using haematoxylin-eosin (H & E) and periodic acid-schiff (PAS) stain. Results: The study included 28 males and 5 females with a median age of 61 yr (range 30-90 yr). Massive pulmonary oedema and thrombi in the lungs were the characteristic features macroscopically. On microscopic examination, diffuse alveolar damage in the exudative/proliferative phase was found in 29 (87.88%) cases. Among the other notable microscopic findings were bronchopneumonia and lung abscesses due to secondary bacterial infection (n=17, 51.52%), acute tubular injury (n=21, 63.64%) and thrombi in the lungs, heart, and kidneys. Interpretation & conclusions: COVID-19 primarily affected the respiratory and the renal systems in the vast majority of severely affected patients in our study. We also found signs of hypercoagulability, as evidenced by widespread thrombi in multiple organs, along with a raised d-dimer level and a hyperinflammatory state manifested by elevated inflammatory markers. Our autopsy findings and altered laboratory investigations support

Study of medial end of fourth ribs with special reference to changes in pit shapes according to age, a qualitative approach.

Background: The objectives of this study were to find changes of pit shape at sternal end of fourth ribs in accordance with age in males, to find bilateral variability in changes of pit shape according to age and to compare the data with previous study. Methods: Total 180 ribs were obtained from male cadavers brought for post-mortem examination. Out of which 140 ribs belonged to 70 cases were included in the study. Each rib was classified according to different stages of pit shape. The data derived were statistically analysed. Results: Pit shape changes from shallow dent to „V‟, from „V‟ to „U‟, from „U‟ to „wide mouth U‟ up to sixties of age and after that the quality of the walls surrounding the pit decreases without changes in shape of pit. There was no any bilateral variation found in pit shape changes for age. Conclusions: Changes of pit shape at sternal end of fourth ribs are age dependent without bilateral variations. Age estimation by this method gives general idea about the age in decades only